Provider Demographics
NPI:1154034247
Name:HUSTON, ERICA (FNP-C, CSWS)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HUSTON
Suffix:
Gender:F
Credentials:FNP-C, CSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9300
Mailing Address - Country:US
Mailing Address - Phone:769-243-6141
Mailing Address - Fax:769-208-4439
Practice Address - Street 1:1108 BELMONT PL
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-3707
Practice Address - Country:US
Practice Address - Phone:769-243-6141
Practice Address - Fax:769-208-4437
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA228919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA228919OtherNP LICENSE